Workplace factors related to work retention
| Workplace factors | Sample (n) | Country | Findings | Source |
| Work accommodation | 47, severe TBI | Great Britain | Combination of work trials, assistance from coworker or fewer working hours during a period after RTW related to continuous employment for at least 1 year since injury (p=0.05). | Johnson (1987) |
| Workload (hours/week) (40 hours/week=full time) | 319, mild TBI | The Netherlands | Work load related to complete RTW after 6 months in a U-shaped curve: less than 25 hours a week related to highest odds of RTW, 32 hours a week related to lowest odds of complete RTW, followed by increased odds with increasing work load (OR 1.25, 95% CI 0.71 to 2.20). Workload not related to complete RTW 12 months after injury | de Koning et al (2017) |
| Regularity of occupational assistance (sporadic vs regular) | 100, TBI | France | Regular versus sporadic occupational assistance: threefold increase in RTW 2–3 years after injury (χ2=3.73, p<0.05), no significant increase after 4–8 years | Bonneterre et al (2013) |
| Workplace intervention tailored according to functional ability and workplace challenges | 80, stroke | South Africa | Intervention group 5.2 times greater odds of returning to work at 6 months than control group | Ntsiea et al (2015) |
| Vocational rehabilitation programme with multidisciplinary assessment, stakeholder meetings (including family, employer and coworker), on-the-job training and coaching | 58, ABI | The Netherlands | Average increase of 5.3 hours of work per week at long-term (circa 4–7 years postinjury) compared with immediately after (around 1 year after injury, p<0.01) the intervention. On average, employees worked 5.9 hours of work per week less than before the injury (p<0.01); no control group | van Dongen et al (2018) |
| Workplace support (present vs not present) | 100, TBI | France | Support at the workplace related to RTW 2–3 years after injury (adjusted OR 15.13, 95% CI 3.17 to 61.74) and 4–8 years (adjusted OR 6.47, 95% CI 1.96 to 21.34) | Bonneterre et al (2013) |
| Blue collar (‘manual’ activity) vs white collar (‘intellectual’ activity) | 76, ABI | France | Blue-collar and white-collar workers demonstrated circa the same rate of RTW (blue collar 28/49=57%, white collar 15/27=55%; p>0.99) | Autret et al (2015) |
| Manual, business or professional labour* | 141, stroke | India | Higher RTW in professional and business jobs (adjusted OR 3.02, 95% CI 1.44 to 6.34) compared with manual jobs | Bonner et al (2016) |
| Professional/managerial (eg, executive or managerial function) or skilled (eg, sales and administrative support) or manual labour (eg, machine operators and private household)* | 319, mild TBI | The Netherlands | Manual and professional (compared with skilled) labour related to the lowest odds of complete RTW after 6 months (both OR 0.38), occupational status not related to complete RTW after 12 months | de Koning et al (2017) |
| Manual versus desk worker, manager versus non-manager* | 382, stroke | Japan | Manual workers had a longer time to resignation than non-manual workers (HR=0.24, 95% CI 0.07 to 0.80). Managers had shorter time to full RTW than non-managers 1 year after the first day of sick leave postinjury (HR=1.68, 95% CI 1.02 to 2.78). Controlled for age and sex in both models, and for desk worker/non-desk-worker in second model | Endo et al (2016) |
| Occupational class (DISCO-88 classification: (1) legislators, senior officials and managers; (2) technicians and associate professionals; (3) workers in occupations that require basic skills; (4) workers in elementary occupations; (5) gainfully occupied people with unknown occupation)* | 19903, stroke | Denmark | Lower odds of RTW among workers in elementary occupations (refrence group) than those with occupations requiring basic skills 1.50 (95% CI 1.38 to 1.64), technicians and associated professionals 2.33 (95% CI 2.05 to 2.65), and professionals 3.04 (95% CI 2.70 to 3.43) | Hannerz et al (2011) |
| White-collar versus blue-collar occupations | 183, stroke | Japan | Higher adjusted OR of successful RTW among white-collar compared with blue-collar workers (OR 5.16, p<0.05)* | Saeki et al (1995) |
| White-collar, blue-collar and self-employed dichotomised (yes/no) (Swedish socioeconomic classification)* | 120, stroke | Sweden | Higher OR of RTW for white-collar workers (compared with others) was 2.99 (p<0.063),* and non-significant for blue-collar workers (0.59, p=0.83) 6 months postinjury. Self-employed was not analysed further after non-significant relationship with RTW on preliminary analysis | Vestling et al (2003) |
| Professional/managerial, skilled or manual labour (The International Standard Classification of Occupations)* | 1926, TBI | USA | Higher odds of RTW for professional/managerial workers (OR 2.959, p<0.05) and skilled workers (OR 1.536, p<0.05) compared with manual workers. ORs adjusted for age, gender, education and severity are 3.155 and 1.706, respectively) | Walker et al (2006) |
| Enterprise size (micro, 1–9 employees; small, 10–49; medium, 50–249; large, ≥250 employees) | 12106, stroke | Denmark | Large enterprise (≥250 employees) size related to RTW after 2 years (p=0.034). Each increase in enterprise size category was followed by an increase in the odds of RTW. | Hannerz et al (2012) |
| Enterprise size (≤999 or ≥1000 employees) | 382, stroke | Japan | Enterprise size unrelated to RTW and resignation 1 year after first sickness absence day when controlled for age and sex | Endo et al (2016) |
*Studies assessing manual occupational role included in evidence synthesis (strong or moderate). Sample refers to he number of participants according to the response rate. Only exposures and outcomes fulfilling inclusion criteria and tested for statistical significance are presented.
ABI, acquired brain injury; RTW, return to work; TBI, traumatic brain injury.